Individual
ELIZABETH BROOKE HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LSW
Contact information
Practice address
624 MARKET AVE N, CANTON, OH 44702-1017
(330) 454-7066
Mailing address
624 MARKET AVE N, CANTON, OH 44702-1017
(330) 454-7066
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
S.1200974
OH
171M00000X
Case Manager/Care Coordinator
S.1200974
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S.1200974
COUNSELOR, SOCIAL WORKER AND MARRIAGE AND FAMILY THERAPIST BOARD
OH
Enumeration date
01/14/2013
Last updated
01/14/2013
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